The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis
Abstract
Background: Antenatal depression can have harmful consequences for the mother and fetus. Exercise may be a useful intervention to prevent and treat antenatal depression. Objectives: This systematic review aims to establish whether there is sufficient evidence to conclude that exercise is an effective intervention for preventing and treating antenatal depression. Search strategy: Searches using electronic databases from MEDLINE , C ochrane L ibrary, CINAHL , EMBASE , AMED and P syc INFO were performed. Selection criteria: Randomised controlled trials ( RCT ) that compared any type of exercise intervention with any comparator in pregnant women were eligible for inclusion. Data collection and analysis: Meta‐analysis was performed calculating standardised mean differences ( SMD ). Main results: Six trials (seven comparisons) were eligible for inclusion. Meta‐analysis showed a significant reduction in depression scores ( SMD −0.46, 95% CI −0.87 to −0.05, P = 0.03, I 2 = 68%) for exercise interventions relative to comparator groups. The test for subgroup differences in women who were non‐depressed (one trial) ( SMD −0.74, 95%CI −1.22 to −0.27, P = 0.002) and depressed (five trials) ( SMD −0.41, 95% CI −0.88 to 0.07, P = 0.09) at baseline was not significant ( P = 0.32). The test for subgroup differences between aerobic (one trial) and non‐aerobic exercise (five trials) was also nonsignificant ( P = 0.32). Authors' conclusions: We found some evidence that exercise may be effective in treating depression during pregnancy but this conclusion is based on a small number of low‐moderate quality trials with significant heterogeneity and wide confidence intervals.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The preference for psychotherapy is marked among adolescents, young adults, women, and minority ethnic groups, as well as those with prior experience with psychological treatments and more severe symptoms of depression.
“The preference for psychotherapy is marked among adolescents, young adults, women, and minority ethnic groups, 385,386,388 as well as those with prior experience with psychological treatments and more severe symptoms of depression. 386,389”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [385]
Multiple systematic reviews describe a consistent preference among both the general public and people diagnosed with depression for counselling and other psychotherapy interventions over antidepressants.
“Multiple systematic reviews describe a consistent preference among both the general public and people diagnosed with depression for counselling and other psychotherapy interventions over antidepressants. 384-386”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [385]
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987) · British Journal of Psychiatry · doi:10.1192/bjp.150.6.782 · Cited by 14,183 · see citing works
Perinatal Depression: A Systematic Review of Prevalence and Incidence
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000183597.31630.db · Cited by 3,282 · see citing works
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215 · see citing works
Verhagen, A., de Vet, H. D., de Bie, R. D., Kessels, A., Boers, M., Bouter, L., & Knipschild, P. (1998) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(98)00131-0 · Cited by 2,473 · see citing works
Artal, R., & O'Toole, M. (2003) · British Journal of Sports Medicine · doi:10.1136/bjsm.37.1.6 · Cited by 723 · see citing works
The Antidepressive Effects of Exercise: A Meta-Analysis of Randomized Trials
Rethorst, C. D., Wipfli, B. M., & Landers, D. M. (2009) · Sports Medicine · doi:10.2165/00007256-200939060-00004 · Cited by 541 · see citing works
Major Depression and Antidepressant Treatment: Impact on Pregnancy and Neonatal Outcomes
Wisner, K. L., Sit, D. K. Y., Hanusa, B. H., Moses‐Kolko, E. L., Bogen, D. L., Hunker, D. F., Perel, J. M., Jones-Ivy, S., Bodnar, L. M., & Singer, L. T. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.08081170 · Cited by 400 · see citing works
Cooper, P., Murray, L., Wilson, A., & Romaniuk, H. (2003) · PubMed · Cited by 390 · see citing works
Vieten, C., & Astin, J. (2008) · Archives of Women's Mental Health · doi:10.1007/s00737-008-0214-3 · Cited by 369 · see citing works
Cooper, P. J., Murray, L., Wilson, A., & Romaniuk, H. (2003) · British Journal of Psychiatry · doi:10.1192/bjp.182.5.412 · Cited by 356 · see citing works
Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery
Mancuso, R. A., Schetter, C. D., Rini, C. M., Roesch, S. C., & Hobel, C. J. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000138284.70670.d5 · Cited by 291 · see citing works
A meta-analysis of treatments for perinatal depression
Sockol, L. E., Epperson, C. N., & Barber, J. P. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.03.009 · Cited by 287 · see citing works
Li, D., LIU, L., & Odouli, R. (2008) · Human Reproduction · doi:10.1093/humrep/den342 · Cited by 283 · see citing works
Yoga and massage therapy reduce prenatal depression and prematurity
Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2011.08.002 · Cited by 198 · see citing works
Yoga and social support reduce prenatal depression, anxiety and cortisol
Field, T. M., Diego, M., Delgado, J., & Medina, L. (2013) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2013.03.010 · Cited by 191 · see citing works
Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances
Field, T. M., Diego, M., Delgado, J., & Medina, L. (2012) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2012.10.001 · Cited by 161 · see citing works
Robledo-Colonia, A. F., Sandoval-Restrepo, N., Mosquera-Valderrama, Y. F., Escobar-Hurtado, C., & Ramírez-Vélez, R. (2012) · Journal of Physiotherapy · doi:10.1016/s1836-9553(12)70067-x · Cited by 156 · see citing works
Daley, A., Jolly, K. B., & MacArthur, C. (2009) · Family Practice · doi:10.1093/fampra/cmn101 · Cited by 100 · see citing works
Self-citationDoes exercise during pregnancy prevent postnatal depression?: A randomized controlled trial
SONGØYGARD, K. M., STAFNE, S. N., EVENSEN, K. A. I., SALVESEN, K. Å., VIK, T., & MØRKVED, S. (2012) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2011.01262.x · Cited by 85 · see citing works
Antenatal depression: a rationale for studying exercise
Shivakumar, G., Brandon, A. R., Snell, P. G., Santiago-Munoz, P. C., Johnson, N. L., Trivedi, M. H., & Freeman, M. P. (2010) · Depression and Anxiety · doi:10.1002/da.20777 · Cited by 68 · see citing works
Field, T., Deeds, O., Diego, M., Hernandez-Reif, M., Gauler, A., Sullivan, S., Wilson, D., & Nearing, G. (2009) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2008.10.002 · Cited by 62 · see citing works
Pilling, S., Adams, H., Barlow, J., Bavetta, M., Clarke, S. D., Day, A., Demilew, J., Grayson, K., Grégoire, A., Jones, I. R., et al. (2014) · Cited by 62 · see citing works
Adverse effects of antidepressant use in pregnancy: an evaluation of fetal growth and preterm birth
Einarson, A., Choi, J., Einarson, T. R., & Koren, G. (2009) · Depression and Anxiety · doi:10.1002/da.20598 · Cited by 54 · see citing works
Yoga Reduces Prenatal Depression Symptoms
Mitchell, J., Field, T. M., Diego, M., Bendell, D., Newton, R. R., & Peláez, M. (2012) · Psychology · doi:10.4236/psych.2012.329118 · Cited by 35 · see citing works
USSHER, M. H., Aveyard, P. N., Manyonda, I., Lewis, S., West, R., Lewis, B. A., Marcus, B. H., Taylor, A. H., Barton, P. M., & Coleman, T. J. (2012) · Trials · doi:10.1186/1745-6215-13-186 · Cited by 34 · see citing works
Prenatal Depression and Selective Serotonin Reuptake Inhibitors
Field, T. M. (2010) · International Journal of Neuroscience · doi:10.3109/00207450802338697 · Cited by 25 · see citing works
Parker, G. B., Crawford, J., & Hadzi‐Pavlovic, D. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01196.x · Cited by 18 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
Pedersen, B. K., & Saltin, B. (2015) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12581 · Cited by 3,514 · see citing works
Time for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104 · see citing works
ACOG Committee on Clinical Practice Guidelines–Obstetrics (2023) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000005200 · Cited by 294 · see citing works
Physical activity during pregnancy and postpartum depression: systematic review and meta- analysis
Nakamura, A., van der Waerden, J., Melchior, M., Bolze, C., El-Khoury, F., & Pryor, L. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.009 · Cited by 186 · see citing works
Poyatos‐León, R., García‐Hermoso, A., Sanabria‐Martínez, G., Álvarez‐Bueno, C., Cavero‐Redondo, I., & Martínez‐Vizcaíno, V. (2017) · Birth · doi:10.1111/birt.12294 · Cited by 175 · see citing works
Perinatal depression and infant mental health
Goodman, J. H. (2019) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2019.01.010 · Cited by 154 · see citing works
Underwood, L., Waldie, K. E., D’Souza, S., Peterson, E. R., & Morton, S. M. B. (2017) · Maternal and Child Health Journal · doi:10.1007/s10995-016-2191-x · Cited by 77 · see citing works
Hill, B., Skouteris, H., Teede, H. J., Bailey, C., Baxter, J.-A. B., Bergmeier, H. J., Borges, A. L. V., Harrison, C. L., Jack, B., Jorgensen, L., et al. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8122119 · Cited by 65 · see citing works
Lin, P.-Z., Xue, J.-M., Yang, B., Li, M., & Cao, F.-L. (2018) · Archives of Women's Mental Health · doi:10.1007/s00737-018-0835-0 · Cited by 28 · see citing works
Munro, N. R., Teague, S., Somoray, K., Simpson, A., Budden, T., Jackson, B., Rebar, A., & Dimmock, J. (2026) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-110301 · Cited by 23 · see citing works
Canfield, S. M., & Canada, K. E. (2023) · Journal of Perinatal & Neonatal Nursing · doi:10.1097/jpn.0000000000000658 · Cited by 7 · see citing works
- Authors
- Daley, A., Foster, L., Long, G., Palmer, C., Robinson, O., Walmsley, H., & Ward, R.
- Affiliations
- Primary Care Clinical Sciences University of Birmingham Birmingham UK
- University of Birmingham (GB)
- ORCID
- Ward, R
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2014-06-17
- Volume
- 122
- Issue
- 1
- Pages
- 57-62
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2138051429
- Cited by
- 137
- References
- 29
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 9 · 2023: 17 · 2022: 14 · 2021: 19 · 2020: 13 · 2019: 10 · 2018: 13 · 2017: 11 · 2016: 7 · 2015: 9 · 2014: 3
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- antenatal depression, exercise intervention, aerobic exercise, pregnant women, maternal mental health
- MeSH terms
- Depression, Depressive Disorder, Exercise Therapy, Female, Humans, Pregnancy, Pregnancy Complications, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
